MEDICARE: SAVANNAH SPRINGS REHAB CORP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	261QP2000X	Physical Therapy Clinic/Center

General Provider Information

NPI Number	:	1376566398
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAVANNAH SPRINGS REHAB CORP

Provider Business Mailing Address
First Line	:	1005 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4103
Country	:	US
Telephone Number	:	305-805-1920
Fax Number	:	305-805-1940

Provider Business Practice Location Address
First Line	:	1005 E 4TH AVE
Second Line	:
City	:	HIALEAH
State	:	FL
Zip	:	33010-4103
Country	:	US
Telephone Number	:	305-805-1920
Fax Number	:	305-805-1940

Authorized Official
Title or Position	:	PRESIDENT
Name	:	GIRALDO MARTINEZ
Credential	:
Telephone Number	:	305-827-0420

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	11/08/2007

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